Andersen Lasse Ø, Husted Henrik, Otte Kristian S, Kristensen Billy B, Kehlet Henrik
Departments of Anesthesiology, Hvidovre University Hospital, Copenhagen, Denmark.
Acta Orthop. 2008 Dec;79(6):806-11. doi: 10.1080/17453670810016894.
High-volume local infiltration analgesia has been shown to be an effective pain treatment after knee replacement, but the role of bandaging to prolong analgesia has not been evaluated.
48 patients undergoing fast-track total knee replacement with high-volume (170 mL) 0.2% ropivacaine infiltration analgesia were randomized to receive a compression or a non-compression bandage, and pain was assessed at rest and with mobilization at regular intervals for 24 h postoperatively.
Pain at rest, during flexion, or on straight leg lift was lower for the first 8 h in patients with compression bandage than in those with non-compression bandage and with a similar low use of oxycodone. Mean hospital stay was similar (2.8 days and 3.3 days, respectively).
A compression bandage is recommended to improve analgesia after high-volume local infiltration analgesia in total knee arthroplasty.
大量局部浸润镇痛已被证明是膝关节置换术后一种有效的疼痛治疗方法，但绷带包扎对延长镇痛效果的作用尚未得到评估。
48例行快速通道全膝关节置换术且接受170毫升0.2%罗哌卡因大量浸润镇痛的患者被随机分为接受加压绷带或非加压绷带组，并在术后24小时定期评估静息和活动时的疼痛情况。
在最初8小时内，使用加压绷带的患者静息、屈曲或直腿抬高时的疼痛程度低于使用非加压绷带的患者，且羟考酮的使用量也相似。平均住院时间相似（分别为2.8天和3.3天）。
建议在全膝关节置换术中使用加压绷带，以改善大量局部浸润镇痛后的镇痛效果。
